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China: A long-term cohort study published in Diabetes Care has shed light on how changes in body mass index (BMI) from childhood to adulthood impact the risk of developing cardiovascular-kidney-metabolic (CKM) syndrome in midlife. Conducted by Yang Wang and colleagues from the Department of Cardiovascular Medicine at the First Affiliated Hospital of Xi’an Jiaotong University, the 36-year study provides important evidence on how early-life weight trends shape long-term health outcomes. The research, based on the Hanzhong Adolescent Hypertension Study, followed 1,997 participants aged 6 to 18 years at baseline, tracking them into their late 40s (mean age 48.12 years). Participants were categorized into four BMI trajectory groups: persistently normal, incident overweight (normal BMI in childhood shifting to overweight in adulthood), persistent overweight, and resolved overweight (high childhood BMI that normalized by adulthood). The study revealed the following findings:Individuals whose BMI changed from normal in childhood to overweight in adulthood had a significantly higher risk of developing more severe stages of cardiovascular-kidney-metabolic syndrome in midlife.Compared to those with persistently normal BMI, these individuals had over five times the odds of progressing to intermediate CKM stage 2 (odds ratio [OR] 5.19).They also had nearly seven times the risk of reaching advanced CKM stages 3–4 (OR 6.70).This BMI transition pattern was associated with higher rates of diastolic heart dysfunction, early kidney damage, albuminuria, and metabolic abnormalities.Conversely, children with elevated BMI who achieved normal weight by adulthood did not face elevated risks.Their CKM risk profiles were similar to those of individuals who maintained a normal BMI from childhood through adulthood.“Transitioning from normal weight in childhood to overweight in adulthood poses a substantial risk to cardiometabolic and renal health in midlife,” noted the authors. “However, if elevated childhood BMI resolves by adulthood, these risks are significantly diminished.”CKM syndrome encompasses a spectrum of interconnected disorders involving the heart, kidneys, and metabolic systems. It progresses in stages, with early intervention seen as key to preventing irreversible health outcomes later in life. The study's use of multivariable regression models allowed for a nuanced understanding of how BMI changes interact with the different components of CKM syndrome over time.These findings emphasize the long-term consequences of weight gain during adulthood and highlight the potential benefits of maintaining or achieving a healthy BMI early in life. The researchers emphasize that efforts to prevent adult weight gain—particularly among those with normal childhood weight—could play a crucial role in mitigating midlife health risks related to the heart, kidneys, and metabolism.Reference:Yang Wang, Yang Yang, Jing Chen, Ming-Fei Du, Yue Sun, Dan Wang, Hao Jia, Gui-Lin Hu, Zi-Yue Man, Teng Zhang, Sheng-Hao Zuo, Chao Chu, Ming-Ke Chang, Ze-Jiaxin Niu, Ying Xiong, Hao Li, Shi Yao, Lei Chen, Jie Ren, Yu-Ming Kang, Zu-Yi Yuan, Duo-Lao Wang, Gregory Y. H. Lip, Zheng Liu, Jian-Jun Mu; Transition of BMI Status From Childhood to Adulthood and Cardiovascular-Kidney-Metabolic Syndrome in Midlife: A 36-Year Cohort Study. Diabetes Care 2025; dca250027. https://doi.org/10.2337/dca25-0027
